Ouch! What to Do If Sex with Your Partner is Painful

Intimacy and sex are an important part of any relationship, yet often times life can get in the way. Hectic work and social calendars, children, and even just sheer exhaustion can sometimes hinder even the most sexually charged relationships, and that’s all quite normal.

Yet there’s one thing that’s never normal: pain.

"Painful sex should never be ignored," says Dr. Jaclyn Bonder, Medical Director of Women’s Health Rehabilitation at New York-Presbyterian and Weill Cornell Medicine, “because it is not supposed to hurt. However, if it is accompanied by symptoms of an infection such as fevers, chills, vaginal itching, or abnormal discharge, or bleeding, you must see your doctor as soon as possible.”

Where to Turn

When a woman is experiencing painful intercourse, Dr. Bonder advises they should see their gynecologist or family practitioner first. “If these healthcare providers are not able to determine the cause of their pain,” she says, “they can see other specialists who treat painful sex and pelvic pain, such as a pelvic rehabilitation physician or a pelvic floor physical therapist.

She stresses that painful sex and pelvic pain is never normal and there are a few misconceptions surrounding the issue citing that some may think, “it is normal for some people,” “it is all in your head, if a doctor can’t find a clear-cut diagnosis for the pain,” or that, “treatments for it are limited by those that a gynecologist can offer.” When in fact, there are other healthcare providers who can help.

Possible Causes

Painful sex can unfortunately stem from numerous underlying issues. Dr. Bonder explained that diagnoses can range from, “gynecologic diseases such as endometriosis or pelvic inflammatory disease, infections, pelvic floor muscle dysfunction or injury, pelvic floor spasms, trauma to pelvic bones or muscles, nerve entrapment or injury, and even pain at the entrance to the vagina from skin, hormonal or nerve problems.”

Treatment Options

Treating pelvic pain during sex ultimately depends on the underlying cause, but can range from antibiotics, to surgery, and physical therapy. Bonder explained, “Physical therapy can be helpful, especially when there are many overlapping diagnoses causing tightness in the pelvic floor muscles.” Additionally, medications such as muscle relaxers, nerve pain medications and even depression/anxiety medications may also serve as helpful treatments. Surprisingly, injections can also offer relief in the form of nerve blocks, trigger point injections or botulinum toxin. (Yep, that’s Botox.)

Self-Advocacy

When dealing with such a sensitive subject matter, it’s extremely important to be your own advocate. It’s important to tell your doctor about any and all symptoms that you have, but also, Bonder stresses, “Do not stop seeing providers until you can find someone who can help, because it is never all in your head and there are many treatment options available that specialists who treat pelvic pain can offer.”